PROVIDER INFORMATION ABOUT BUPIVACAINE LIPOSOMAL INJECTION (EXPAREL®)
What is BUPIVACAINE LIPOSOMAL INJECTION (Exparel®)?
Liposomal bound bupivacaine (using DepoFoam®) with slow release technology and duration of ~ 72-96 hours
Approved for wound infiltration into surgical site to produce post-surgical analgesia
- Pivotal studies performed in: Bunionectomies, hemorrhoidectomies, hernia repairs, thoracotomies
- Protocol recently approved for total joints to replace infusion pain pumps
Tmax: ~ 2 hours T ½: ~ 36 hours Duration of Action: ~ 72-96 hours (4 days)
Possible Side Effects
Monitoring of cardiovascular and neurological status, as well as vital signs should be performed during and after injection of EXPAREL as with other local anesthetic products. Because amide-type local anesthetics, such as bupivacaine, are metabolized by the liver, EXPAREL should be used cautiously in patients with hepatic disease. Patients with severe hepatic disease, because of their inability to metabolize local anesthetics normally, are at a greater risk of developing toxic plasma concentrations.
In clinical trials, the most common adverse reactions (incidence ≥10%) following EXPAREL administration were nausea, constipation, and vomiting.
Exparel and your patient
Because local anesthetics, including lidocaine, may cause an immediate release of bupivacaine from
EXPAREL if administered together resulting in neurologic or cardiac toxicity, local anesthetics should NOT be administered within 96 hours following administration of EXPAREL. Lidocaine can be administered locally at areas other than the surgical site.
Because of this risk, your patient was provided with an EXPAREL Patient Notification Card to alert any health care professional (physician, dentist, surgeon, pharmacist, etc) of date and time of Exparel administration and the 96 hour duration of action.
The identification card should be used by the patient for 96 hours (4 days) after surgery. Once this time period has passed, Exparel’s duration is complete, and the risk for local anesthetic interaction should be minimal.